Barry Seemungal (PhD FRCP) is a neurologist who researches the brain mechanisms of vestibular function and dysfunction, with a focus on vestibular cognition. He was born and raised in Trinidad, West Indies, studied medicine in Cardiff and initially trained as an endocrinologist in Oxford and then as a neurologist in London, completing a PhD in vestibular neurosciences ('The Mechanisms and Loci of Vestibular Perception') at the Institute of Neurology, Queen Square, London. Dr Seemungal has received research funding from the Academy of Medical Sciences and Health Foundation Clinician Scientist Fellowship Programme, the Medical Research Council UK, the EPSRC, Imperial College Charities and the Friends of St Mary's.
SELECTED RECENT PUBLICATIONS
Yousif N, Fu R, Bourquin B, Bhrugubanda V, Schultz SR, Seemungal BM. Dopamine preserves visual motion perception despite noise interference of human V5/MT. Journal of Neuroscience 2016 (accepted - 27th June). In Press.
Kaski D, Quadir S, Nigmatullina Y, Malhotra PA, Bronstein AM, Seemungal BM. Temporoparietal encoding of space and time during vestibular-guided orientation. Brain. 2016 Feb;139(Pt 2):392-403. [OPEN ACCESS].
Yousif N, Bhatt H, Bain PG, Nandi D, Seemungal BM. The effect of pedunculopontine nucleus deep brain stimulation on postural sway and vestibular perception. Eur J Neurol. 2016 Mar;23(3):668-70. [OPEN ACCESS]
Nigmatullina Y, Hellyer PJ, Nachev P, Sharp DJ, Seemungal BM. The neuroanatomical correlates of training-related perceptuo-reflex uncoupling in dancers. Cereb Cortex. 2015;25:554-62. [OPEN ACCESS].
Seemungal BM, Guzman-Lopez J, Arshad Q, Schultz SR, Walsh V, Yousif N. Vestibular activation differentially modulates human early visual cortex and V5/MT excitability and response entropy. Cereb Cortex. 2013 Jan;23(1):12-9. [OPEN ACCESS].
Seemungal BM. The cognitive neurology of the vestibular system. Curr Opin Neurol. 2014 Feb;27(1):125-32.
(Consensus paper) Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J, Bisdorff A, Versino M, Evers S, Newman-Toker D. Vestibular migraine: diagnostic criteria. J Vestib Res. 2012;22(4):167-72. [OPEN ACCESS].
TEACHING & DEVELOPING GUIDELINES
Online learning tools - NHS ENGLAND. See London Strategic Clinical Network Website:
Guidance for clinicians who are non-experts in vertigo -
Taken from: Seemungal. Curr Op in Neurology. 2007.
Member of the Barany Society involved in the working group that published the first classification for vestibular migraine.
Registered expert on the European Research and Innovation database.
Expert review of the United Kingdom ‘NICE’ guidelines for vertigo & dizziness.
Chaired a European conference on Brain Plasticity in the Vestibular system (‘FENS’ Satellite conference – 2014).
Association of British Neurologists Acute Neurology Advisory Group member.
This includes masterclasses on managing dizziness at the Royal College of Physicians, at BMJ Masterclasses in India and at the 1st and 2nd European Academy of Neurology (EAN) meetings in Berlin (2015) and Copenhagen (2016).
Participates in the Trust acute neurology rota. Provides an acute vertigo service with colleagues (Prof Adolfo Bronstein) at Imperial Healthcare NHS Trust. Together, they provide an acute vertigo service to the Trust A&E's, Hyperacute Stroke Unit at Charing Cross and the Major Trauma Unit at St Mary’s Hospital.
The Brain Mechanisms and Loci of Human Vestibular Perception.
A particular theme of our research is the uncoupling of perception and reflex function in the vestibular and ocular-motor system. We have published a brain imaging study which showed that the vestibular cerebellar grey matter is key in modulating sensations of dizziness separate from vestibular ocular reflex responses. In addition, we have demonstrated an extensive white matter cortical network involved in mediating vertigo sensation. These findings in healthy humans were corroborated in a recent human lesion study in which the loci of vestibular perception were probed in acute stroke patients.
Vestibular Mechanisms and Human Brain Diseases.
We are now extending our techniques into understanding the higher-order vestibular contributions to neurodegenerative diseases such as Parkinson's Disease. Our recent work aims to understand the brain mechanisms underlying effects upon balance function with novel deep brain stimulation targets in Parkinson's patients.
The Mechanisms of Brain Plasticity and Treating Balance Disorders.
BRAIN PLASTICITY OF THE VESTIBULAR AND OCULAR MOTOR SYSTEMS. FENS SATELLITE MEETING (3-4Th July, 2014, Como, Italy)
This meeting focused on the brain plasticity in the vestibular and ocular motor systems. The speakers were from a variety of backgrounds including electrophysiology, pharmacology, optogenetics, computational modelling, scientific studies of human brain function as well as clinical studies. (Conference webpage).
BRAIN PLASTICITY IN HEALTH AND DISEASE
Environmental change or change in our ‘internal milieu’ due to disease, poses a challenge to the survival of the individual. Brain plasticity is a key contributor to our remarkable capacity to adapt to external or internal change. Such plasticity is utilised in rehabilitation regimens be they physical or cognitive behavioural therapy. Occasionally brain plasticity may go wrong and cause symptoms. In my clinic a common if under-recognised condition called Visually-Induced Dizziness, may be due to such brain plasticity gone wrong.
We use the well characterised vestibular and ocular motor systems to measure and understand brain mechanisms of plasticity. By understanding brain plasticity better we aim to improve treatments for brain diseases that can be affected by the brain processes of plasticity.
LAB TO BEDSIDE
How the dancer’s brain adapts to repeated pirouetting.
We recently demonstrated the brain adaptation in dancers that enable them to suppress dizziness following a pirouette. We found that the vestibular cerebellum grey matter changed in line with the amount of training dancers did. This publication was covered in the media locally and internationally (see news). We are translating these findings in developing a new therapy for chronic dizzy patients. Together with colleagues from Kings College London and University College London, we are developing a dance-based treatment for patients with chronic dizziness. We also aim to combine this therapy with medication to speed recovery from chronic dizziness. We will also apply a modified version of this therapy to other neurological conditions such as rehabilitation for stroke patients.
FIGURE TAKEN FROM NIGMATULLINA ET AL. CEREB CORTEX 2015
Does dopamine D1 / D2 receptor modulation affect visual motion perceptual function? A potential novel role for dopamine in early sensory processing.
Taken from Yousif et al. 2016 J Neurosci. In Press.
When processing sensory signals, the brain must account for noise, both in the stimulus and that arising from within its own neuronal circuitry. Dopamine receptor activation is known to enhance both visual cortical signal-to-noise-ratio (‘SNR’) and visual perceptual performance, however it is unknown if these two Dopamine-mediated phenomena are linked. To assess this link we used single pulse transcranial magnetic stimulation (TMS) applied to visual cortical area V5/MT to focally reduce the SNR, and hence disrupt visual motion discrimination performance to visual targets located in the same retinotopic space. The hypothesis that Dopamine receptor activation enhances perceptual performance by improving cortical SNR predicts that Dopamine activation should antagonise TMS-disruption of visual perception. We assessed this hypothesis via a double-blinded, placebo controlled study with dopamine receptor agonists Cabergoline (D2 agonist) and Pergolide (D1/D2 agonist), administered in separate sessions (separated by 2 weeks) in 12 healthy volunteers in a William’s balance-order design. TMS degraded visual motion perception when the evoked-phosphene and the visual stimulus overlapped in time and space, in the Placebo and Cabergoline conditions but not with Pergolide. This suggests that Dopamine D1 or combined D1 and D2 receptor activation, enhances cortical SNR to boost perceptual performance. That local visual cortical excitability was unchanged across drug conditions suggests the involvement of long-range intra-cortical interactions in this D1 effect. Since increased internal noise (and hence lower SNR) can impair visual perceptual learning, then improving visual cortical SNR via D1/D2 agonist therapy may be useful in boosting rehabilitation programmes involving visual perceptual training.
Our goal is to utilise a knowledge of the brain mechanisms of plasticity to help improve treatment, not just for patients with vestibular or eye movement problems but also for those with chronic neurological conditions such as traumatic brain injury, stroke or multiple sclerosis. We aim to use adjuvant therapy such as brain stimulation and drugs, to enhance plastic change and hence speed recovery with physical and cognitive therapy.
et al., 2016, Temporoparietal encoding of space and time during vestibular-guided orientation, Brain, Vol:139, ISSN:0006-8950, Pages:392-403
et al., 2015, The Neuroanatomical Correlates of Training-Related Perceptuo-Reflex Uncoupling in Dancers, Cerebral Cortex, Vol:25, ISSN:1047-3211, Pages:554-562
et al., 2013, Vestibular Activation Differentially Modulates Human Early Visual Cortex and V5/MT Excitability and Response Entropy, Cerebral Cortex, Vol:23, ISSN:1047-3211, Pages:12-+
Seemungal BM, 2007, Neuro-otological emergencies, Current Opinion in Neurology, Vol:20, ISSN:1350-7540, Pages:32-39
Guzman-Lopez J, Silvanto J, Seemungal BM, 2011, Visual motion adaptation increases the susceptibility of area V5/MT to phosphene induction by transcranial magnetic stimulation, Clinical Neurophysiology, Vol:122, ISSN:1388-2457, Pages:1951-1955